Kugonjetsa Mankhwala Angayambe Kulimbitsa Matenda Aakulu Okhudza Matenda a Mtima
Ambien (ogulitsidwa monga generic zolpidem) amalembedwa kuti apange chithandizo cha kusowa tulo, koma kodi chingathandize matenda ena a ubongo monga coma, ziweto zosaleka, dystonia, matenda a Parkinson, stroke, dementia, ndi kuvulala kwa ubongo? Lipoti la zochitika ndi kafukufuku waung'onoting'ono amasonyeza kuti angathe kupeza phindu, ndipo ndemanga imalimbikitsa kufufuza mozama pa ntchito ya mankhwala mu mankhwala osayenera.
Kodi Ambien Amachita Bwanji Ubongo?
Zigolenge (yogulitsidwa monga Ambien, Ambien CR, ndi Intermezzo) ndi mankhwala omwe amagwiritsidwa ntchito ndi mankhwala ndi mankhwala kuti athe kuchipatala. Zimasankha ndipo zimagwiritsa ntchito mtundu wa gamma-aminobutyric acid A (GABA A) benzodiazepine receptor. Izi zingathandize kuchepetsa ntchito za mbali zina za ubongo, kumalimbikitsa kugona ndi kupondereza chidziwitso. Zingayambitse kuwonjezeka kwa kugona kwa REM pochepetsa ntchito ya dopamine, zotsatira zomwe zingathenso kuwonjezera ma prolactin .
Ambien amagwira ntchito mofulumira, kufika pachimake m'magazi pambuyo pa maola 1.6 akudya. Ilibe metabolites yogwira ntchito. Mu maola osachepera atatu (ndi maimidwe oyenera kuyambira 1.5 mpaka 2.4 maola), magulu a magazi a Ambien amachepetsedwa ndi theka. Kulingalira kotulutsidwa (kugulitsidwa monga Ambien CR) ili ndi theka la 1.5 mpaka 4.5 maora.
Chifwamba chimatulutsidwa mu mkodzo kudzera impso.
Ngakhale kuti chithandizo chofunika kwambiri cha ogona, Ambien akhoza kukhala ndi zotsatira zochepa pa khalidwe la kugona. Pamene 10 mg watengedwa, zikhoza kuchepetsa nthawi yomwe imatenga nthawi yokhala ndi mphindi zisanu kapena ziwiri zokha. Zingachepetse nthawi yowonjezera yowuka usiku ndi mphindi 25 zina.
Kodi zingakhudze bwanji vuto lina lomwe limakhudza ubongo?
Udindo wa Ambien pochiza Matenda a Mitsempha
Ofufuza kuchokera ku yunivesite ya Michigan akhala akufotokozera mwachidule zolemba za sayansi momwe zolpidem zingakhudzire zinthu zina zomwe zimakhudza kwambiri ubongo, kuphatikizapo coma, dystonia, stroke, ndi dementia. Zina mwa zomwe apezazi zingakhale zolimbikitsa kwa iwo amene akulimbana ndi kuvulazidwa kwakukulu ndi kuwonongeka kwa ubongo.
Martin Bomalaski, MD, ndi anzake agwiritsa ntchito nkhani 2314 zomwe zafalitsidwa kudzera pa March 20, 2015. Pambuyo powerenga zolembazo, mipukutu yonseyi inayankhidwa pazinthu 67. Ambiri mwa malipotiwa anali ndi mayesero ang'onoang'ono komanso malipoti, zomwe zikuyimira umboni wathanzi. Ndipotu, maphunziro 11 okhawa anali ndi anthu oposa 10 Panali mayesero 9 okha olamuliridwa, omwe amawerengedwa ngati golide wa kafukufuku wa zamankhwala. Izi zingakhudze kutanthauzira zotsatira zake ndi kufunika kwa anthu akuluakulu.
Panali magulu angapo a mavuto omwe zolpidem ayesedwa:
- Matenda a magulu (maphunziro 31) - matenda a dystonia ndi Parkinson
- Kusokonezeka kwa chidziwitso (maphunziro 22) - nthendayi komanso chikhalidwe chokhazikika
- Matenda ena a ubongo (maphunziro 14) - kupweteka , kuvulala kwa ubongo, kuvutika maganizo , ndi matenda a maganizo
Ofufuzawa anafufuza nkhani za mtundu wa matenda omwe amachitidwa, kuchuluka kwa zolpidem zomwe amagwiritsa ntchito, kuchuluka kwa dosing, zotsatira zoyipa, ndi zotsatira zoyipa zomwe zimachitika.
Kodi Ndondomeko Ziti Zidatchulidwa Ndi Chithandizo Chambiri?
Panali zizindikiro zosiyanasiyana zomwe zinayesedwa, kuyambira kuvutika kulankhula (aphasia), kusowa kwa chisamaliro (kusasamala), ndi mavuto oyendayenda okhudzana ndi kusowa kwa magalimoto. Mayankhowa anali oyenerera bwino ndi miyeso yambiri yovomerezeka yogwiritsidwa ntchito poyeza coma, matenda a Parkinson, dystonia, ndi mavuto ena.
Kawirikawiri, zolpidem zinapereka mpumulo wambiri: makamaka kusintha, ngati kuwonedwa, kunangokhala maola ola limodzi okha. Zosinthazi zinali kubwereza, zomwe zimafuna kuti pakhale mlingo wafupipafupi chifukwa cha hafu ya moyo wa mankhwalawa. Zopititsa patsogolo zinawoneka mu luso lamagetsi, langizo, ndi luso. Odwala ena osakanikirana kapena osakanikirana amawoneka bwino, ndipo ochepa adayesa kulankhula.
Panalinso maphunziro omwe adawonetsa kusintha kwa ntchito zokhudzana ndi ubongo, zomwe zikusonyeza kuti kusintha kwa ubongo ndi kugwirizanitsa kwa ubongo. Zopambana zitha kukhalapo kwa odwala omwe amavulala kwambiri, mbali ya ubongo yomwe imathandizira kukonza chidziwitso kuti zigwirizane ndi kayendetsedwe kafunidwe kapena magalimoto.
Zotsatira zake zinali zofanana ndizo: zolpidem ikukwera pansi. Izi zingachititse kugona ndipo zinafotokozedwa mwa odwala asanu ndi awiri (55) omwe anayesera. Popeza zizindikirozo ziyenera kuti zikhale bwino pakutha, izi zikhoza kukhala zoperewera kwambiri kugwiritsa ntchito mankhwalawa. Pamene kuwonjezera kumakhudza kukumbukira kukumbukira, zingathenso kuganiza kuti pangakhale zovuta pa kukumbukira kwa kanthawi kochepa . Monga anthu omwe adagwiritsira ntchito mankhwalawa akhala osowa kwambiri pazomwe akuyambira, kuyamikira kwathunthu zotsatirapo kungasokonezedwe.
Tsoka ilo, zolpidem sizigwira ntchito kwa aliyense. Ndipotu, odwala 5 mpaka 7 peresenti ya odwala omwe ali ndi matenda okhudza chidziwitso adayankha mankhwalawa. Izi zikutanthauza kuti mpaka 95 peresenti ya anthu omwe adagwiritsa ntchito izo sizinasinthe bwino m'maganizo awo. Pazinthu zomwe zili ndi vuto la kusinthana, ziwerengerozo zinali zoposa, kufika 24 peresenti.
Ambiri sanachitepo kanthu kwa mankhwalawa, koma ali ndi njira zingapo zothandizira, zolinga zamakono zingakhale zokondweretsa mabanja omwe akusowa mwayi wowonjezera.
Mawu Ochokera
Ngakhale mayankhowa ndi mayesero ang'onoang'ono a zachipatala angawoneke olimbikitsa, ndibwino kuti mabanja ndi abwenzi a iwo omwe ali ndi vuto lalikulu la ubongo kuti atanthauzire zotsatira izi ndi mlingo waukulu wa pragmatism. Zingatheke kuti zolpidem sizingathandize odwala ambiri omwe akuvutika ndi matendawa olepheretsa kwambiri. Komabe, pakhoza kukhala chifukwa cha chiyembekezo: kufufuza kwina n'koyenera.
Sitikudziwa bwino momwe zolpidem zingasinthire mkhalidwe umenewu. Zikutheka kuti zimakhudza kuchuluka kwa ziwalo za ubongo ndi kugwirizana pakati pa mbali zosiyanasiyana za ubongo. Mwachifaniziro, ngati ubongo umakhala wopanda vuto chifukwa cha kusalingana kwa mphamvu zotsutsa, zingathandize kuthetsa nkhondoyo m'njira yabwino. Njirazi ziyenera kufotokozedwa. Mayesero akuluakulu ofufuza zachipatala angatithandizire kumvetsetsa omwe ali ndi vuto lalikulu la matenda a ubongo adzapindula ndi kugwiritsa ntchito zolpidem-ndipo chifukwa chiyani.
> Zotsatira:
> Bomalaski, MN et al . "Chifwamba cha Chithandizo cha Matenda a Neurologic: Kusanthula Kwambiri." JAMA Neurol . Idasindikizidwa pa intaneti pa June 26, 2017. do: 10.1001 / jamaneurol.2017.1133.
Kilduff, TS ndi Mendelson, WB. "Mankhwala Opatsirana: Njira Zogwira Ntchito ndi Zotsatira za Pharmacologic," mu Mfundo ndi Zochita za Sleep Medicine . Kusinthidwa ndi Kryger MH, Roth T, Dement WC. St. Louis, Missouri, Elsevier Saunders, 2017, p. 429.
> Miyazaki, Y et al. "Kuchita bwino kwa zolpidem kwa dystonia: phunziro pakati pa magawo osiyanasiyana." Front Neurol . 2012 Apr 17; 3: 58.
> Sateia, MJ ndi al . Malangizo Okhudza Zipatala Zothandizira Mankhwala Osokoneza Bongo a Insomnia Osaneneka Akuluakulu: An American Academy of Sleep Medicine Guide Guide Practice Practice . " Journal of Clinical Sleep Medicine . 2017; 13 (2) 307-349.
> Sutton, JA ndi Clauss, RP. "Kubwereza umboni wa zolpidem zothandiza mu ubongo wa ubongo pambuyo pa kuwonongeka kwa ubongo chifukwa cha kukwapulidwa, kupsinjika mtima ndi hypoxia: Kulungamitsidwa kwa mayesero ena ochipatala." Ubongo Inj . 2017; 31 (8): 1019-1027.